Alzheimer’s disease (AD) is a condition that comes on not all at once, but in stages. When it begins as mild cognitive impairment (MCI), its effects are so subtle that the patient and those closest to them might not even realise what’s happening. Unfortunately, this hard-to-detect MCI is also the stage at which interventions can be the most effective.
An artificial intelligence (AI) dementia diagnosis app developed by UK-headquartered Cognetivity is aiming to boost MCI diagnosis rates, so that Alzheimer’s patients can receive the best possible treatment.
The software, which can be downloaded on to an iPad, consists of an image categorisation test designed to engage specific areas of the brain affected in early and pre-symptomatic stages of Alzheimer’s. As the app user categorises the images as being either animal or non-animal, the software detects subtle impairments in information processing speed, to try and catch the earliest signs of the disease before the onset of significant symptoms.
“You can postpone the change from MCI to mild AD by having a better lifestyle,” says Cognetivity CEO Dr Sina Habibi. “All these brain training games, reading, having a better diet, doing more exercise, socialising, all of this has a huge impact on postponing or preventing onset of dementia. When you can diagnose patients at this stage, you can encourage them to take those steps and keep them at MCI level for longer.”
Monitoring patients with MCI
Sunderland GP Alliance, a federation of 35 primary care practices in the north-east of England, is currently using Cognetivity’s platform to monitor patients with MCI. The alliance is offering periodic image categorisation assessments to patients with MCI as part of a pilot programme, enabling deterioration to be identified and treatment to begin as soon as possible.
Cognetivity’s test has some substantial benefits over traditional pen-and-paper assessments. It takes only five minutes to complete, and is able to eliminate cultural and educational biases – regardless of a person’s background, they’ll be able to grasp the concept of an animal/non-animal categorisation test.
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The test has also proven beneficial in the wake of the Covid-19 pandemic.
“Getting a cognitive test is not one of those frontline, Covid-related activities, and so it’s been shut down,” Habibi says. “The waiting time has also been extended as a result, so this is a huge problem. At the moment, in clinics, we have built some pieces of technology to make remote testing a possibility. The idea at the time was that when patients arrive you could actually administrate the test in the waiting room so that when they go and see their general practitioner or psychiatrist they already have a cognitive test result.
“Now, we want to take that one level further. We want to do this at home.”
While the test was initially designed to be taken semi-supervised in clinics, with a nurse or administrator talking the patient through how it works, Cognetivity is now developing an instructional video to replace this so the platform can go fully remote. iPads will then be delivered to patients’ homes to enable them to take the assessment remotely, without travelling outside and risking Covid-19 exposure.
A busy year ahead for Cognetivity
Cognetivity is planning its international expansion too. The company expects to receive approval from the US Food and Drug Administration in Q3 2021, and has already been accepted on to an accelerator programme at Texas Medical Center.
“This is not a conventional accelerator where you go in with an idea and you come out with a prototype. You go in with a full-on product and you go out with market validation,” says Habibi. “170 companies applied for this cohort, only five made it though, and only one non-American company made it through – that’s us.”
The product will be put in front of personal care practitioners and psychiatrists in the US to assess the user needs of the market, so that the company is prepared once its FDA approval comes through.
The firm has also been awarded a place in Innovate UK EDGE’s Scaleup Programme, a government-funded scheme supporting a select group of companies. The programme is highly selective, and issues invitations only to companies assessed as having the potential to achieve compound annual growth rates (CAGRs) of at least 50%.
Innovate UK has also provided substantial funding in the past, awarding the firm a grant of nearly £1m in 2019 to deploy its assessment technology throughout the NHS in collaboration with Alzheimer’s Research UK.
“We give GPs the tools to monitor MCI patients a lot more carefully and a lot more proactively, so that they can send in patients as soon as their situation gets worse and they pass from MCI to mild AD,” says Habibi. “This is something which has never been done, to our knowledge, in the UK or anywhere else. It’s very exciting.”